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cialties, but what sets them apart, in the eyes of patients/customers (i.e. the Unique Selling Propositions), are the quality of care, personal attention, pleasant atmosphere for in-patients, and cost effectiveness. It was decided to adopt the BSC approach as part of a strategic change designed to reposition Vinzenz-Gruppe on the market by: • redefining the group’s portfolio of activities, in terms of both consistency and effectiveness; • enhancing their political clout; • acquiring new facilities; • identifying new strategic partners. For VG, the BSC model is based on the following 5 perspectives or axes: • strategic success; • financial; • customers and markets; • internal; • learning and growth. The main difference between VG and the two abovementioned cases lies in the financial perspective, which is justified by the private ownership structure of the group. VG adopted a particularly interesting approach towards defining indicators, using the 4 dimensions illustrated in Figure 4. Figure 4 – Dimensions employed by VG to define indicators Format qualitative qualitative Timeframe Dimension ex-ante ex-post internal external financial non financial [201] Focus CEIS Health Report 2006
CEIS Health Report 2006 In a nutshell, VG was able to achieve the following results above all by clarifying future strategic guidelines following the introduction of the BSC system: • a shared vision (by the Board of Directors, Management and Order of St. Vincent); • redefined mission statements, as per critical masses; • a set of clearly defined plans and priorities; • a business plan for the Holding company and for each Group hospital; • a list of possible acquisitions (hospitals and clinics); • a more corporate, though still Christian, mindset; • better alignment between the organization structure and the new strategies, e.g. by reviewing membership of the Board of Directors; • definitely stronger political support at the local, regional and national level. 3.5.5 Conclusions Based on this analysis of three different setting, it is obvious that it is too soon for the healthcare industry to consider implementing the Balanced Scorecard in terms of the original model defined by Kaplan and Norton. Instead, numerous variants have arisen from the different ways in which the subject has been approached. The authors believe there are several critical factors associated with the specific corporate setting that actually determine how closely the ideal model can be replicated. When comparing public with private organizations, the multidimensional aspect appears to be the foremost discriminating factor: in the private sector, the 4 perspectives tend more often than not to be divided with a view to better understanding the factors that determine profit; conversely, in the public sector the economic performance is viewed as a partial and incomplete goal, alongside many other non-financial aims that the BSC should at least identify. If economic performance is thus a necessary but insufficient condition for hospitals, then the environment is obviously complex enough to require tools such as the Balanced Scorecard which, once they have become entrenched, should help to reduce the complexity level itself. Moreover, the multidimensional factor also leads to a different analysis of perspectives: in the private sector the accent is primarily on the economic aspect while in the public sector the economic perspective is never far removed from that of the customer/patient. Hence yet another difference regarding the focus on financial resources, which is obviously less acute in public organizations and a less trenchant factor in steering healthcare policy. Another element that determines the gap between the ideal model and the cases described here concerns the unique nature of healthcare organizations. Being skills-based organizations par excellence, hospitals are unrelentingly faced with the problem of having different categories of professionals operating under the same roof. The BSC should be able to help hospitals foster better dialogue, participation and cooperation between management and professionals: the problem of finding causal links between the economic perspective and the customer perspective could be solved if such links were part and parcel of relations between the parties (i.e. managers and physicians) who could actually influence these perspectives through their actions. The organization would thus gain greater benefit from the links formed between people than from those enforced determi- [202]
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CEIS Health Report 2006 Management
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CEIS Health Report 2006 Management
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Index Report Presentation by Pagane
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1.6 - The Regional Primary Care Agr
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Chapter 3 - Efficiency 3.1 - The Ef
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3.8 - Private Health Insurance and
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Ceis - Sanità Report presentation
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Warning The figures in the volume f
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CEIS Health Report 2006 stantial, i
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CEIS Health Report 2006 If, therefo
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CEIS Health Report 2006 Cross-check
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CEIS Health Report 2006 over € 6.
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CEIS Health Report 2006 made; final
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CEIS Health Report 2006 Although th
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CEIS Health Report 2006 Aside from
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CEIS Health Report 2006 Regulations
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CEIS Health Report 2006 especially
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Chapter 1 Health expenditure and fu
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CEIS Health Report 2006 The questio
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CEIS Health Report 2006 Table 1 - T
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CEIS Health Report 2006 Figure 3 -
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CEIS Health Report 2006 ciated with
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CEIS Health Report 2006 ● OECD (2
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CEIS Health Report 2006 the phenome
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CEIS Health Report 2006 Table 3 - R
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CEIS Health Report 2006 The indicat
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CEIS Health Report 2006 References
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CEIS Health Report 2006 All the var
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CEIS Health Report 2006 Diagram 1 -
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CEIS Health Report 2006 1.4 - Pharm
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CEIS Health Report 2006 % Pharmaceu
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CEIS Health Report 2006 The second
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CEIS Health Report 2006 tion of res
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CEIS Health Report 2006 Table 4 - R
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CEIS Health Report 2006 The variati
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CEIS Health Report 2006 1.5 - The r
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CEIS Health Report 2006 southern Re
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CEIS Health Report 2006 1.5.5 Absor
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CEIS Health Report 2006 For day hos
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CEIS Health Report 2006 There is co
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CEIS Health Report 2006 1.6 - The r
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CEIS Health Report 2006 the Primary
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CEIS Health Report 2006 Table 1 - T
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CEIS Health Report 2006 • “phys
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CEIS Health Report 2006 1.7 - Evolu
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CEIS Health Report 2006 As can be o
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CEIS Health Report 2006 Another int
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CEIS Health Report 2006 Some signif
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CEIS Health Report 2006 1.7.5 Concl
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CEIS Health Report 2006 [114]
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Introduction Public deficit in the
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CEIS Health Report 2006 The cumulat
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CEIS Health Report 2006 tegies of i
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CEIS Health Report 2006 gest that t
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CEIS Health Report 2006 increase of
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CEIS Health Report 2006 increase in
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CEIS Health Report 2006 [130]
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CEIS Health Report 2006 It is also
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CEIS Health Report 2006 shifting be
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CEIS Health Report 2006 year (AIHW
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CEIS Health Report 2006 cost of the
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CEIS Health Report 2006 The Second
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CEIS Health Report 2006 2.5 - Imple
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CEIS Health Report 2006 2.5.3 Shift
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CEIS Health Report 2006 Table 1 - P
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CEIS Health Report 2006 and, conseq
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Page 164 and 165: hospital stays has reduced the aver
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Page 168 and 169: CMS = f(COST, CMP, PL, RC, DM , PME
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Page 174 and 175: 3.3.3 Cooperation with the Regional
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Page 194 and 195: cooperation to achieve the developm
Page 196 and 197: However, to manage a multi-site hos
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Page 202 and 203: nistically or quantitatively. Hence
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Page 210 and 211: ● Kaplan R, Norton D (1992), “T
Page 212 and 213: 3.7 - The management of healthcare
Page 214 and 215: Table 1 - Pathway for st elevated a
Page 216 and 217: [217] CEIS Health Report 2006 Table
Page 218 and 219: Vaginal childbirth Some synthesis i
Page 220 and 221: Politiche sanitarie, marzo-aprile.
Page 222 and 223: dental work, the purchase or rental
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Page 226: ● OECD (2004), “Towards High -
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Page 232 and 233: Table 2 - Association indexes betwe
Page 234 and 235: 4.1.5 Structure of health expenditu
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Page 245 and 246: CEIS Health Report 2006 sence of di
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5.1 - The median age at death for m
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causes and the median age at genera
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in the South and Islands, not only
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5.2 - Analysis of avoidable deaths
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population of Italian citizens acco
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We wish to underline the mortality
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Diagram 4 - % composition of years
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5.2.4 Comments The results of the a
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among whites and blacks,1979-1989
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Figure 1 - Division % of the quota
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Figure 3 - Pharmaceutics expenditur
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Table 3 - Gross fixed investments i
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Table 4 - Share of medical device w
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age dimension of enterprises (90 em
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BOX 2: National Medical Device Clas
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maceutiche in Italia (1997-2001)”
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5.4 - Mobility of italian patients
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Authority (ASL) will be charged for
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43.950.716,00. At this stage, if yo
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esting data are certainly provided
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have carried out economic and stati
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[295] CEIS Health Report 2006
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✔ DE POUVOURVILLE GÉRARD Researc
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✔ MENNINI FRANCESCO SAVERIO Degre
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✔ SCHWEIGER ARTURO Health Economi
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